Power morcellation in a protected environment

ABSTRACT

A power morcellation system, apparatus, and methodology. Structurally, the device includes a sturdy, pliable (e.g., able to be inserted and retracted through a 10-15 mm morcellator port), distensible, waterproof/watertight retaining bag/pouch/carrier to be deployed into the pelvic cavity of the subject. The device further includes a plurality (e.g., three (3)) of port tube channels extending outwardly from the bag, wherein the interior of each channel is in communication with the interior of the bag. Each channel has an open end (opposite from the end that terminates in the bag) through which a laparoscopic/robotic camera and other instruments (e.g., camera, control instrument) may pass. A smaller tube channel also extends outwardly from the bag and can be suited as an insufflation port channel, among other uses. The bag also includes a large opening surrounded by an elastic drawstring for receiving the specimen to be removed within the bag.

CROSS-REFERENCE TO RELATED APPLICATIONS

This nonprovisional application is a continuation of and claims priorityto U.S. Provisional App. No. 61/983,819, entitled “Power Morcellation ina Protected Environment”, filed Apr. 24, 2014, and U.S. Provisional App.No. 62/019,097, entitled “Power Morcellation in a ProtectedEnvironment”, filed Jun. 30, 2014, both of which are incorporated hereinby reference in their entireties.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention relates, generally, to morcellators. More specifically,it relates to power morcellation in a protected environment in order toeliminate the risk of tumor spread.

2. Brief Description of the Prior Art

Since the introduction of minimally invasive gynecologic surgeries inthe late 1990s, millions of patients have benefited enormously from thistechnological advancement. Minimally invasive hysterectomy andmyomectomy through either traditional laparoscopy or robotic assistancehas been possible due to the use of open mechanical power morcellationas a means of retrieving the surgical specimen.

While this open mechanical power morcellation has been advantageous infacilitating these complex surgeries, it has the disadvantage ofpotentially spreading previously undiagnosed uterine malignancy duringthe process. See R. Barbieri, Benefits and pitfalls of open powermorcellation of uterine fibroids, OBG Manag. 2014; 26(2): 10-15, whichis incorporated herein by reference. Recently, the Food & DrugAdministration (“FDA”) issued a safety communication discouraging theuse of open laparoscopic power morcellation for the surgical removal ofthe uterus following hysterectomy or uterine fibroids followingmyomectomy in women. This safety communication was issued because thistype of procedure poses the risk of disseminating unsuspected malignanttissue, such as uterine sarcomas. To continue to harness the multiplebenefits of minimally invasive gynecologic surgeries, it is imperativethat laparoscopic surgeons devise a safe alternative to current openpower morcellation.

Attempts have been made to overcome the drawbacks of open mechanicalpower morcellation. For example, U.S. patent application Ser. No.13/725,148 to Shibley et al. discusses a pneumoperitoneum device havinga tissue bag that is inserted through a laparoscopic port of a subject.Generally, a tissue bag with an opening into its interior and ringelement defining the opening is inserted into the body through thelaparoscopic port. The bag is manipulated to place an excised tissue(e.g., uterus) inside the bag. The ring element is then pulled outsidethe body through the laparoscopic port. At this point, a number oflaparoscopic tools can be inserted into the bag through the port toinsufflate and morcellate the excised tissue therewithin. Shibley et al.also contemplates a trocar (though another laparoscopic port) piercingthe bag after insufflation for insertion of other tools. When the tissueis morcellated or otherwise ready for removal, the bag enclosing thetissue is pulled out of the original laparoscopic port to remove thetissue. However, there are several drawbacks to this methodology. Ittakes additional time to fold and pull the ring element into and out ofthe laparoscopic port. There is also the potential for unnecessarycomplications (i.e., similar to those found in previous openmorcellation procedures) by not sealing the bag within the body andpulling the open top out through the port. Insufflating after pullingthe ring out of port also limits the number of ports and tools that canaccess the interior of the bag, as there are risks of compromising theinsufflation when piercing the insufflated bag.

Accordingly, what is needed is a power morcellation system thateliminates the risk of inadvertent tissue dissemination via morcellationin a protected environment and does not disrupt the existing endoscopicworkflow. However, in view of the art considered as a whole at the timethe present invention was made, it was not obvious to those of ordinaryskill in the field of this invention how the shortcomings of the priorart could be overcome.

While certain aspects of conventional technologies have been discussedto facilitate disclosure of the invention, Applicants in no way disclaimthese technical aspects, and it is contemplated that the claimedinvention may encompass one or more of the conventional technicalaspects discussed herein.

The present invention may address one or more of the problems anddeficiencies of the prior art discussed above. However, it iscontemplated that the invention may prove useful in addressing otherproblems and deficiencies in a number of technical areas. Therefore, theclaimed invention should not necessarily be construed as limited toaddressing any of the particular problems or deficiencies discussedherein.

In this specification, where a document, act or item of knowledge isreferred to or discussed, this reference or discussion is not anadmission that the document, act or item of knowledge or any combinationthereof was at the priority date, publicly available, known to thepublic, part of common general knowledge, or otherwise constitutes priorart under the applicable statutory provisions; or is known to berelevant to an attempt to solve any problem with which thisspecification is concerned.

SUMMARY OF THE INVENTION

The long-standing but heretofore unfulfilled need for an improved, moreeffective and lower cost shape-shifting surface is now met by a new,useful, and nonobvious invention.

In an embodiment, the current invention is a morcellation system. Thesystem includes a flexible retaining bag, pouch, or carrier with aspecimen-receiving opening that leads from an exterior of the retainingbag to a substantially hollow interior of the retaining bag. The bag isinsertable into an abdominal or pelvic cavity of a subject or patient.The bag is structured to receive a targeted, excised specimen within theinterior of the bag. The system further includes a means of tightening,cinching, closing, or sealing the specimen-receiving opening positionedon the perimeter of the opening. A plurality of elongate, flexiblelaparoscopic tool- or trocar-receiving channels extend externally from alining of the retaining bag at a spaced distance away from thespecimen-receiving opening and at a spaced distance away from eachother. The channels are positioned on the lining of the bag, such thatthe channels line up with the laparoscopic ports on a body of thesubject. The channels further are structured to receive one or morelaparoscopic tools. Each channel has a proximal end and a distal end,where the distal end terminates at the body of the retaining bag withinthe operative internal cavity of the subject and the proximal end isexternal to the body of the subject. Each channel also has asubstantially hollow interior that is in communication with the hollowinterior of the retaining bag. The retaining bag has a first positionand a second position. The first position is the bag in a desufflatedposition within the operative internal cavity of the subject with thespecimen-receiving opening being open. The second position is the bag inan insufflated position within the abdominal or pelvic cavity of thesubject with the specimen-receiving opening being closed.

The operative internal cavity of the subject may be an abdominal orpelvic cavity.

The laparoscopic tool(s) inserted into the channels may be a trocar,morcellator, a camera, a control instrument, or an insufflation source.

The specimen-receiving opening can be tightened, cinched, closed, orsealed using a drawstring-type apparatus that is pulled relative to theopening in order to reduce a diameter or length of the opening.Alternatively, the specimen-receiving opening can be retrieved throughone of the ports and tightened against the trocar to maintainpneumoperitoneum.

The channels may include a morcellator channel receiving a morcellator,a camera channel receiving a channel, and a control instrument channelreceiving a control instrument, such that the morcellator couldmorcellate the specimen within the interior of the bag. In this case,the morcellator can morcellator the targeted specimen within theretaining bag under direct visualization of the camera while the controlinstrument holds the specimen.

The channels may each include an elongate suture tag attached to andpositioned at the second end in order to facilitate laparoscopicmanipulation of the channel.

In the second insufflated position, the insufflated bag may be pressedup against the anterior abdominal wall within the subject.

In a separate embodiment, the current invention is a method ofperforming minimally invasive laparoscopic surgery on a subject.Laparoscopic ports are provided in the body of the subject, and thetargeted specimen is excised within the operative internal cavity of thesubject. The morcellation system is inserted into the abdominal orpelvic cavity of the subject in a deflated position. The morcellationsystem includes a retaining bag having a substantially hollow interiorand having a sealable or closeable specimen-receiving opening, where thespecimen-receiving opening provides for completely open communicationbetween the operative internal cavity of the subject and the interior ofthe retaining bag. The morcellation system further includes a pluralityof laparoscopic tool- or trocar-receiving channels extending from thelining of the bag. The channels have a hollow interior that is in opencommunication with the interior of the bag. The channels each have afirst end that terminates at the body of the bag within the abdominal orpelvic cavity of the subject, and a second end that is external to thebody of the subject when the system is inserted into the subject. Thechannels are spatially aligned with the laparoscopic ports on the bodyof the subject and are positioned at a spaced distance away from thespecimen-receiving opening and at a spaced distance from each other.Each channel is withdrawn from the operative internal cavity through itscorresponding, spatially aligned laparoscopic port. The excised specimenis positioned/placed into the interior of the retaining carrier throughthe specimen-receiving opening. The opening is tightened, cinched,closed, or sealed in order to enclose the specimen within the carrier.The interior of the carrier is no longer in completely opencommunication with the operative cavity of the subject. Laparoscopictool(s) are inserted into each channel, so that the distal end of eachlaparoscopic tool is positioned within the interior of the carrier andthe proximal end of each laparoscopic tool is disposed external to thesubject's body. The carrier is then insufflated to distend in order toform a protected environment. The enclosed specimen can then bemorcellated within the insufflated carrier to remove the specimen fromthe operative cavity of the subject. Once completed as much as desired,the retaining carrier can be desufflated and the morcellation systemwithdrawn/removed from the subject's body through a laparoscopic port.The retaining carrier would enclose any remnants of the specimen.

The operative internal cavity of the subject may be an abdominal orpelvic cavity.

The laparoscopic tool(s) inserted into the channels may be a trocar,morcellator, a camera, a control instrument, or an insufflation source.

The specimen-receiving opening can be tightened, cinched, closed, orsealed using a drawstring-type apparatus that is pulled relative to theopening in order to reduce a diameter or length of the opening.

The channels may include a morcellator channel receiving a morcellator,a camera channel receiving a channel, and a control instrument channelreceiving a control instrument, such that the morcellator couldmorcellate the specimen within the interior of the bag. In this case,the morcellator can morcellator the targeted specimen within theretaining bag under direct visualization of the camera while the controlinstrument holds the specimen.

The channels may each include an elongate suture tag attached to andpositioned at the second end in order to facilitate laparoscopicmanipulation of the channel.

The excised, targeted specimen being morcellated may be a uterus in afemale subject.

In the second insufflated position, the insufflated bag may be pressedup against the anterior abdominal wall within the subject.

The step of withdrawing each channel from the operative cavity can beperformed as follows. A grasper can be inserted into a firstlaparoscopic port and withdrawing a first channel. This can be repeatedfor withdrawing a second channel from a second laparoscopic port. Inthis case, the step of tightening the specimen-receiving opening isperformed after withdrawing the first channel but before withdrawing thesecond channel.

The step of withdrawing or removing the morcellation system from theoperative cavity can be performed as follows. Each channel, except forone (1), can be inserted back into the operative cavity after thelaparoscopic tools have been removed. The remaining channel can then bepulled in order to extract the retaining carrier and each channel fromthe operative cavity.

Each of the foregoing steps may be performed under direct visualizationof a camera.

In a separate embodiment, the current invention may be any structure ormethod for performing a surgical procedure in a protected environmentwithin an operative internal cavity of a subject or patient. Thestructure or method can have any one or more of the foregoinglimitations.

These and other important objects, advantages, and features of theinvention will become clear as this disclosure proceeds.

The invention accordingly comprises the features of construction,combination of elements, and arrangement of parts that will beexemplified in the disclosure set forth hereinafter and the scope of theinvention will be indicated in the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

For a fuller understanding of the invention, reference should be made tothe following detailed description, taken in connection with theaccompanying drawings, in which:

FIG. 1 depicts a structure of a power morcellation system according toan embodiment of the current invention.

FIGS. 2A-2D depicts withdrawal of the channels from the cavity, alongwith depicting all four channels extending out of the cavity but withoutany laparoscopic tools inserted therein. FIG. 2A is a cross-sectionalview of a subject's body with a user-operated grasper grasping a channelwithin the cavity. FIG. 2B is a cross-sectional view of the subject'sbody with the channel of FIG. 2A pulled/withdrawn through a laparoscopicport via the user-operated grasper. FIG. 2C is a cross-sectional view ofthe subject's body with four channels each pulled/withdrawn through arespective laparoscopic port. FIG. 2D is a top view of the subject'sbody with four channels each pulled/withdrawn through a respectivelaparoscopic port.

FIG. 3A is a cross-sectional view of a portion of a user's pelvic cavitywith an open retaining bag/carrier contained therein and withlaparoscopic tools inserted into the channels of the system and into theinterior of the retaining bag. A grasper can also be seen attempting tograsp a drawstring for tightening or closing the opening that receivesthe specimen to be removed.

FIG. 3B depicts the positioning of FIG. 3A except with the graspertightening the drawstring in order to tighten or close the opening thatreceives the specimen to be removed. As such, the specimen can be sealedwithin the interior of the retaining bag.

FIG. 4 is a view within an insufflated retaining bag through alaparoscopic camera, showing the control instrument and morcellatorduring morcellation of the blue specimen.

FIGS. 5A-5D depict a process of removal of the morcellation system fromthe subject's body. FIG. 5A depict channels extending out of thesubject's body with laparoscopic tools (other than the camera) removed.FIG. 5B depicts removal of the camera and two of the channels beinginserted back into the abdominal/pelvic cavity of the subject. FIG. 5Cdepicts three of the channels inserted into the abdominal/pelvic cavityof the subject with the morcellator channel still extending out of thesubject's body. FIG. 5D depicts removal of the morcellation system fromthe subject's body through the morcellation port.

FIG. 6 depicts remnants of the specimen remaining contained within theretaining bag even after morcellation and removal of the retaining bagfrom the abdominal/pelvic cavity of the subject or patient.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

In the following detailed description of the preferred embodiments,reference is made to the accompanying drawings, which form a partthereof, and within which are shown by way of illustration specificembodiments by which the invention may be practiced. It is to beunderstood that other embodiments may be utilized and structural changesmay be made without departing from the scope of the invention.

As used in this specification and the appended claims, the singularforms “a”, “an”, and “the” include plural referents unless the contentclearly dictates otherwise. As used in this specification and theappended claims, the term “or” is generally employed in its senseincluding “and/or” unless the context clearly dictates otherwise.

In an embodiment, as seen in FIG. 1, the current invention is a powermorcellation system, generally denoted by the reference numeral 10, thatincludes a sturdy, pliable (e.g., able to be inserted and retractedthrough a ˜10-15 mm morcellator port), distensible,waterproof/watertight/water-resistant retaining bag/pouch/carrier,denoted by the reference numeral 12, to be deployed into an operative ortargeted (e.g., pelvic, abdominal, peritoneal) cavity of a subject orpatient. Carrier 12 also includes large base opening 14 surrounded byelastic drawstring 16 a, 16 b for receiving specimen 22 to be removedwithin carrier 12.

Carrier 12 has a plurality of apertures 18 positioned at a spaceddistance away from opening 14. Aligned with and extending from apertures18 is a plurality (e.g., at least three (3) or four (4)) of port tubechannels 20 extending outwardly from carrier 12, wherein the interior ofeach channel 20 is in communication with interior 15 of carrier 12. Eachchannel 20 has an open proximal end (opposite from the distal end thatterminates in apertures 18 of carrier 12) through which alaparoscopic/robotic camera and other instruments (e.g., camera, controlinstruments, morcellator, etc.) may pass.

Methodologically, upon properly creating laparoscopic ports leading tothe targeted cavity of the subject according to conventional methods,carrier 12 of morcellation system 10 is brought into the endoscopicfield after specimen 22 to be removed is separated from the surroundingtissue. Specimen 22 is placed into carrier 12 via large opening 14 ofcarrier 12, and drawstring 16 a is pulled to tighten surroundingdrawstring 16 b so that large opening 14 is cinched or closed.Drawstring 16 a can optionally be retrieved using an endoscopicCarter-Thompson type retriever needle, passed transabdominally. The neckof the cinched large opening can be held against the anterior abdominalwall, so as to restrict the escape of fluid from the cinched largeopening.

Port channels 20 are individually pulled back through the laparoscopicports (e.g., camera port, morcellator port, control instrument port)that lead to the targeted or operative cavity.

As will become clearer as this specification continues, a smaller tubechannel can also extend outwardly from carrier 12 and can be suited asan insufflation port channel, among other uses. The smaller port channelcan be brought out through a smaller (e.g., 3 mm) trocar port and can beused to insufflate carrier 12. The camera, standard morcellator, andcontrol instruments can then be maintained in or reinserted into carrier12, which is inside the operative (e.g., abdominal) cavity. Carrier 12is insufflated via the insufflation channel, such that it distends toline the peritoneal cavity. Carrier 12 may be able to withstandinsufflation pressures of ˜20-40 hhMg.

The morcellation is conducted in a typical manner, under directvisualization, with the distal end of the camera and control instrumentpositioned within interior 15 of insufflated carrier 12, along with thestandard morcellator and extraction instrument. If extraneous tissuepieces of specimen 22 break free during the morcellation, these areautomatically retained within interior 15 of carrier 12.

When the larger pieces of targeted specimen 22 are removed via themorcellator, carrier 12 can be suctioned to retrieve the smallerremnants, and the instruments can be removed from ports 20. Portchannels 20 can then be tied off, and carrier 12 (which would now besubstantially empty) can be withdrawn sealed and intact via one of ports20, for example the larger morcellator port. Laparoscopic portextraction and closure can be performed in a standard fashion.

In an embodiment, the current invention keeps all tissue pieces inside asealed cavity, eliminating the risk of tissue dispersal into theperitoneal cavity. Morcellation can be accomplished under directvisualization, while the targeted tissue is sealed within the retainingbag or carrier. Normal, healthy, or non-targeted tissue can then be keptor maintained outside of the field of morcellation. The currentmethodology is user-friendly for deployment and extraction of the deviceand contents, and standard laparoscopic/robotic equipment can be used.The invention requires only deployment of the carrier and thus fits intothe existing laparoscopic workflow at a minimal manufacturing cost.

Example

FIGS. 2A-6 depict an exemplary structure and methodology of the powermorcellation system, apparatus, and method, according to an embodimentof the current invention. The morcellation system is generally denotedby the reference numeral 10.

Structure

Structurally, as also seen in FIG. 1, power morcellation system 10includes flexible retaining bag, pouch, or carrier 12 with large,typically circular specimen-receiving opening or aperture 14 that has adiameter/length and leads from the exterior of carrier 12 tosubstantially hollow interior 15 of carrier 12.

The perimeter of specimen-receiving opening 14 can be lined with meansof tightening, cinching or closing 16 b carrier 12 or opening 14 bybringing all sides of the perimeter of opening 14 closer to one another,thus reducing or completely eliminating the diameter/length ofspecimen-receiving opening 14 as means of tightening, cinching, orclosing 16 a, 16 b is actuated. Examples of means of tightening,cinching, or closing 16 a, 16 b include, but are not limited to, adrawstring-type apparatus that can be pulled relative to opening 14 totighten or close opening 14, a monofilament suture that can be tied tocinch opening 14, a locking cable/zip tie-type apparatus that can bepulled relative to opening 14 to seal opening 14, and other knownapparatuses and methods of tightening, cinching, or closingspecimen-receiving opening 14. Through any of these means,specimen-receiving opening 14 can be tightened, cinched, or closed tohinder or prevent insufflating medium (gas) or any tissue inside carrier12 from exiting interior 15 of carrier 12 through the specimen-receivingopening 14.

A plurality of flexible laparoscopic tool- or trocar-receiving channels,generally denoted by the reference numeral 20, extends externally fromcarrier 12 at a spaced distance away from specimen-receiving opening 14.Channels 20 have a proximal end that is closest to user 30 and may befree (i.e., not attached to anything at least initially), and also adistal end that terminates at carrier 12. Channels 20 have asubstantially hollow interior that is in open communication withinterior 15 of carrier 12.

Typically, at least three (3) to four (4) channels are needed—1 for themorcellator, 1 for the control instrument, 1 for the camera, and 1 forinsufflation. However, any number of port channels 20 are contemplatedby the current invention. For example, one of the channels, such as thechannel used for the camera, can also be utilized to link theinsufflation source to substantially hollow interior 15 of carrier 12.Alternatively, another separate channel can be used for the insufflationsource. Alternatively, even just one (1) laparoscopic port can besufficient for the system 10, in particular if a camera is released orimplanted within operative cavity 23 of the subject (see U.S. Pat. No.8,416,342) and/or if a female subject's vagina is used as a laparoscopicport for the morcellator (see PCT App. No. PCT/US2013/050085) and/or ifthe control instrument and insufflation source use the same laparoscopicport using an integrated trocar, for example. One (1) laparoscopic portmay even be suitable if using single-port laparoscopic techniques.

In an embodiment, conventional trocars (not shown) can be placed insideeach channel 20. This can have the advantage of insufflating normallyvia an already-existing channel, such as the camera trocar insufflationpoint. An additional advantage of having a trocar inside each channel 20is that it can facilitate manipulation of laparoscopic instrumentationwithout running the risk of perforating or otherwise damaging flexiblechannels 20.

Laparoscopic tool- or trocar-receiving channels 20 are positioned on andextend from carrier 12 so that channels 20 line up with the normallaparoscopic port placement (see reference numeral 26) on body 24 of thesubject, with appropriate tolerances to allow for variations inplacement of laparoscopic ports 26. Channels 20 are positioned at aspaced distance away from specimen-receiving opening 14 and at a spaceddistance away from each other. Channels 26 typically are elongate andare structured to snugly fit various laparoscopic tools that can extendinto interior 15 of carrier 12 via channels 26.

Each channel 20 may further include a long suture tag (not shown) at itsopen proximal end (opposite from its distal end terminating at retainingcarrier 12) to facilitate laparoscopic manipulation, such as pulling thechannel through the appropriate laparoscopic port 26.

When specimen-receiving opening 14 is tightened, cinched, or sealed viameans 16 a, 16 b, excised tissue or specimen 22 can be sealed orotherwise contained within substantially interior 15 of carrier 12.Cinched opening 14 can be held to the anterior wall of the operative ortargeted (e.g., abdominal, pelvic, peritoneal) cavity through themorcellator port and channel (or other existing laparoscopic port andchannel) using a conventional laparoscopic tenaculum (not shown).

Power morcellation system/apparatus 10, in particular specimen-receivingcarrier 12 and laparoscopic tool- or trocar-receiving channels 20extending therefrom, is typically formed of pliable materials, such asflexible plastics, to permit entry and exit from one or more oflaparoscopic ports 26 (e.g., removing carrier 12 and channels 20 throughthe morcellator port).

Methodology

The following steps are described in a manner and order that is notintended to be limiting of the scope of the current invention. It iscontemplated herein that the order of the steps described herein can bealtered or rearranged so long as the ultimate results of the stepsremain the same or similar. This will become clearer as thisspecification continues.

Laparoscopic ports 26, typically at least three (3) or four (4) or more,are created in body 24 of the subject/patient according to conventionalmethods for surgical positioning of laparoscopic tools 20. If three (3)ports 24 are formed, ports 24 can function as a morcellator port (10-15mm), a camera port, and a control instrument port. One of these portscan be used as the insufflation port as well, or a fourth port can becreated for insufflation. Any number of laparoscopic ports 24 arecontemplated by the current invention. For example, even just one (1)laparoscopic port can be sufficient for the system 10, in particular ifa camera is released or implanted within operative cavity 23 of thesubject (see U.S. Pat. No. 8,416,342) and/or if a female subject'svagina is used as a laparoscopic port for the morcellator (see PCT App.No. PCT/US2013/050085) and/or if the control instrument and insufflationsource use the same laparoscopic port using an integrated trocar, forexample. One (1) laparoscopic port may even be suitable if usingsingle-port laparoscopic techniques.

Targeted tissue 22 (e.g., uterus, fibroid, etc.) is excised withininterior or operative cavity 23 of body 24 using known endoscopicmethods. Upon excising targeted tissue 22 using known methods (e.g., viathe planned or intended morcellator port), the trocar is removed fromthe port (e.g., the planned or intended morcellator port), and the portskin incision can be enlarged as needed. At this point, laparoscopicports 26 have been formed leading from the external environment tointerior 23 (e.g., abdominal or pelvic cavity) of body 24, and targetedtissue 22 is contained within interior 23 (e.g., abdominal or pelviccavity) of body 24.

Next, power morcellation system/apparatus 10 can be inserted intointerior 23 of body 24 of the patient or subject via one of ports 26,typically the largest port, which may be the morcellator port.Flexible/Foldable retaining bag, pouch, or carrier 12 and laparoscopictool- or trocar-receiving channels 20 extending from carrier 12 arepassed through one of laparoscopic ports 26 into operative/peritonealcavity 23, typically under camera visualization.

In addition to the drawstring-type apparatus or other means oftightening, cinching, or closing 16 a, 16 b retaining carrier 12 orspecimen-receiving opening 14, each channel 20 can include a long suturetag (not shown) on its open proximal end (opposite from the distal endof channel 20 terminating in retaining carrier 12) to facilitatelaparoscopic manipulation and manipulation of channels 20. Accordingly,the entirety of power morcellation system 10 is inserted into interior23 of body 24 of the subject, primarily including retaining carrier 12and channels 20. This can be seen in FIG. 2A.

Still referring to FIG. 2A, grasper 28 can subsequently be insertedthrough one of ports 26 (e.g., the morcellator port or skin incision) byuser 30. Grasper 28 can used to withdraw one of channels 20 through oneof ports 26, typically morcellator channel 30 c (see FIGS. 3A-3B)through laparoscopic port 26 that was created for morcellator 32.Morcellator 32 itself can then be passed into retaining carrier 12through morcellator channel 20 c. If needed, morcellator channel 20 ccan be sealed around the morcellator trocar with a suture tie (notshown). Alternatively, control instrument channel 20 a, camera channel20 b, or insufflation channel 20 d can be withdrawn through theirrespective laparoscopic ports 26, rather than withdrawal of morcellatorport 20 c.

At this point or at a later time (or even prior to this point), excisedtissue or specimen 22 can then be placed into interior 15 of retainingcarrier 12 through specimen-receiving opening 14 under cameravisualization using graspers (such as grasper 28) inserted intooperative cavity 23 via operating trocar ports 26. At this point,morcellator channel 20 c has been pulled through its respectivemorcellator port 26, such that the free/proximal end of channel 20 c isexternal to body 24 of the subject, and specimen 22 is positioned withininterior 15 of carrier 12.

At this point or at a later time (or even prior to this point ifspecimen 22 has been placed into interior 15 of carrier 12), opening 14of carrier 12 can be cinched, closed, or sealed via means 16 a, 16 b. Ifa drawstring-type apparatus is used as means of closing 16 a, 16 bspecimen-receiving opening 14, as seen in FIGS. 3A-3B, a sutureretrieval needle (e.g., CARTER-THOMASON type) or other grasper (such asgrasper 28 seen) can be passed transcutaneously through one oflaparoscopic ports 26 to retrieve and/or pull the ends of thedrawstring-type apparatus or other means 16 a, 16 b. This can be done tocinch opening 14, for example against the anterior abdominal wall, toform a relatively airtight seal and secure/clamp drawstring-typeapparatus 16 a in place within operative cavity 23. This can be seen inFIGS. 3A-3B, where FIG. 3A shows opening 14 in an open position and FIG.3B shows opening 14 in a closed or cinched position. Alternatively, aknot can be tied in drawstring 16 a, and opening 14 can be cinched witha knot pusher intracorporeally to ensure airtightness.

Alternatively, the specimen-receiving opening can be retrieved throughone of the ports and tightened against the trocar to maintainpneumoperitoneum.

Though not required, the benefit of withdrawing channel 20 c prior toactuating means 16 a, 16 b is for stability of system 10 duringactuation of means 16 a, 16 b. For example, if means 16 a, 16 b is thedrawstring shown in the figures, then channel 20 c can be held outsideof body 24 of the subject while drawstring 16 a is pulled to tightensurrounding drawstring 16 b. However, depending on which means 16 a, 16b is used, this benefit of withdrawing channel 20 c first may or may notbe needed.

Alternatively, if a cable/zip tie is used as means of tightening orclosing 16 a, 16 b specimen-receiving opening 14, opening 14 can besealed by pulling the cable/zip tie with grasper 28 or a knot pusher.Any known means of tightening or closing 16 a, 16 b is contemplatedherein by the current invention.

At this point or at any suitable time, the camera (seen in FIGS. 3A-3Bas reference numeral 31), which may be used to visualize thepositioning/withdrawal of morcellator channel 20 c (or other channel 20)and the placement of excised specimen 22 into interior 15 of retainingcarrier 12, can be removed from a central (typically camera) port, ifthat is where the camera was inserted, and placed in a side port/trocar.Similar to FIG. 2A, grasper 28 can subsequently be inserted throughrespective camera port or skin incision 26 (under direct visualizationof camera 31) and used to withdraw camera channel 20 b of morcellationsystem 10 through laparoscopic port 26 formed for camera 31. Camera 31can then be removed from the side trocar port and itself passed intointerior 15 of retaining carrier 12 through camera channel 20 b.

At this point or beforehand, grasper 28 can subsequently be insertedthrough laparoscopic port or skin incision 26 formed for controlinstruments and used to withdraw control instrument channel 20 a ofmorcellation system 10 through respective control instrument port 26.Control instrument (such as grasper 28; see FIG. 3B) itself can then bepassed into interior 23 of retaining carrier 12 through controlinstrument channel 20 a.

An insufflation tube can then be attached to the camera trocar oroptionally passed through a separate insufflation channel which would beinserted and withdrawn as discussed with the previous channels. Theinsufflation tube would insufflate the retaining carrier to distend. Ifneeded, the channels can be sealed against the trocars with suture ties.

More specifically, if a separate port is used for insufflation channel20 d, grasper 28 can be inserted through laparoscopic port or skinincision 26 formed for an insufflation source and used to withdrawinsufflation channel 20 d of morcellation system 10 through respectiveinsufflation port 26. Insufflation channel 20 d itself can then bepassed into interior 15 of retaining carrier 12 through insufflationchannel 20 d. The proximal end of insufflation channel 20 d (i.e., theend closes to user 30) can be coupled to a conventional insufflationsource (not shown) for pumping fluid (e.g., air) into carrier 12 throughinsufflation channel 20 d for insufflating carrier 12. As such, becauseopening 14 has been tightened, cinched, or closed via means 16 a, 16 b,the fluid supplied by the insufflation source should be not be able toescape interior 15 of carrier 23, or at the very least, the fluid shouldbe hindered from exiting interior 15 of carrier 23 if opening 14 hasbeen tightened but not closed completely. Insufflating carrier 12 formsa protected environment in which user 30 can morcellate and removetargeted tissue 22 or otherwise perform the necessary procedures.

FIGS. 2A-2D generally depict a process of withdrawing channels 20 fromoperative cavity 23 of a subject or patient after insertion of system 10into body 24 of the subject or patient. FIG. 2A shows a grasper insertedthrough laparoscopic port 26 into operative cavity 23 of the patient orsubject, where grasper 28 has grasped one of channels 20 within cavity23. FIG. 2B shows grasper 28 retracting and withdrawing channel 20through port 26. FIGS. 2C-2D show channels 20 fully withdrawn throughports 26 after grasper 28 has released channels 20. It is contemplatedherein, however, that FIGS. 2A-2D show just one way of withdrawingchannels 20 through laparoscopic ports 26; channels 20 can be withdrawnthrough their respective ports 26 using any contemplated methodology.FIGS. 2C-2D show channels 20 withdrawn through the respectivelaparoscopic ports 26 without any laparoscopic tools or trocars insertedinto channels 20.

Regardless of the order of the foregoing steps of withdrawing channels20 from operative cavity 23 and actuating means 16 a, 16 b to tighten orclose opening 20, the ultimate goal is for channels 20 to be withdrawnfrom cavity 23 and for targeted specimen to be substantially sealedwithin interior 15 of carrier 12. As can be understood, this goal can beaccomplished in a variety of manners, regardless of which of channels 20are withdrawn first, when opening 20 is closed, etc.

Referring back to the exemplary methodology, at this point, channels 20a-20 d have been pulled and withdrawn through laparoscopic ports 26,respectively, such that the free proximal end of each of channels 20a-20 d are external to body 24 of the subject, and excised specimen 22is sealed within interior 15 of carrier 12 after actuation of means 16a, 16 b. As seen in FIG. 3B, control instrument 28, camera 31,morcellator 32, and insufflation source 34 extend into or are incommunication with substantially hollow interior 15 of carrier 12. Asdiscussed, for each channel 20 a-20 d that is withdrawn from body 24 ofthe subject through its respective port 26, a suture tag (not shown) canbe attached to the free proximal end of each channel 20 a-20 d in orderfacilitate the withdrawal of channels 20 a-20 d from operative cavity 23of the subject.

With these components of morcellation system 10 in place, morcellationof excised specimen/tissue 22 is performed under direct visualization ofcamera 31 (inserted through camera channel 20 b), where fragments ofspecimen 22 can be morcellated and withdrawn by morcellator 32 throughmorcellator channel 20 c and respective port 26. FIG. 4 shows a viewfrom camera 31 within insufflated carrier 12, where control instrument28 holds specimen 22 and morcellator 32 morcellates and removes specimen22.

After morcellation is satisfactorily completed, retaining carrier 12 canbe completely desufflated. Control instrument 28 and morcellator 32 canbe withdrawn from channels 20 a and 20 c, respectively, with theirrespective trocars, leaving control instrument channel 20 a andmorcellation channel 20 c extending externally from body 24 of thesubject (FIG. 5A). The free/proximal end of control instrument channel20 c can be tied off, and channel 20 c itself can be pushed back intooperative cavity 23 of the subject. Removal of insufflation source 34and insufflation port 20 d can occur in substantially a similar manner.See FIG. 5B.

Camera 31 may remain in camera channel 20 b through this process for thepurpose of visualization, but beforehand or afterwards, camera 31 can bewithdrawn from camera channel 20 b with its respective trocar, leavingcamera channel 20 b extending externally from body 24 of the subject(FIG. 5B). The free/proximal end of camera channel 20 b can be tied off,and channel 20 b itself can be pushed back into operative cavity 23 ofthe subject. See FIG. 5C.

Morcellator 32 can be removed, if not previously removed, andsubsequently, the intact, desufflated retaining carrier 12, along withcontrol instrument channel 20 a, camera channel 20 b, and camera channel20 c—all of which are within body 24 of the subject—can be withdrawn vialaparoscopic port 26 that was formed for morcellator 32 (assuming themorcellator port is the largest in size). To do this, as can be seen inFIG. 5D, user 30 can simply pull morcellator channel 20 c to withdrawpliable carrier 12 and pliable channels 20 a-20 d from interior 23 ofbody 24 of the subject. Though typically morcellator channel 20 c islargest in size/diameter, it is contemplated herein that removal ofsystem 10 can occur through any suitable port 26.

Regardless of the order of the foregoing steps of removing thelaparoscopic tools from channels 20 or how cavity 23 is visualized orwhich of channels 20 are inserted back into cavity 23, the ultimate goalis for system 10 to be entirely withdrawn from cavity 23 through atleast one of laparoscopic ports 24. As can be understood, this goal canbe accomplished in a variety of manners, regardless of which of toolsare removed first, which of channels 20 are pushed into cavity 23, whichof ports 24 is used for withdrawing system 10, etc.

As can be seen in FIG. 6, remnants 22′ of specimen 22 that were notwithdrawn via morcellator 32 remain contained within retaining carrier12 throughout the morcellation procedure and even after withdrawal frombody 24 of the subject.

At this point, all laparoscopic instruments can be cleaned and replacedin the laparoscopic ports, as necessary, to inspect operative/peritonealcavity 23. When satisfied, the port fascia can be closed using knownmethods. The remaining procedure can be performed using known methods aswell.

GLOSSARY OF CLAIM TERMS

Applying a force: This term is used herein to refer to an act ofmanipulating a structure to act in a manner desired. As an example ofthe current invention, a pulling force can be applied to a withdrawnchannel in order to extract the entire morcellation system (andcomponents thereof, i.e., retaining carrier, other channels, etc.) fromthe inside of a patient or subject.

Control Instrument: This term is used herein to refer to anylaparoscopic tool that can be used in holding or stabilizing a specimenor tissue during operation of the surgical procedure, for example duringmorcellation of the specimen or tissue.

Desufflate: This term is used herein to refer to a fluid (e.g., gas)exiting a wholly or partially inflated reservoir or carrier such thatthe reservoir or carrier is no longer inflated.

Direct visualization: This term is used herein to refer to the abilityof a user or operator (e.g., surgeon) to consistently see or recognizethe procedure being performed within the interior of the subject orpatient.

Distal: This term is used herein to refer to a position of a structurethat is closer to the interior of a subject or patient than anotherstructure that is closer to a user or operator (e.g., surgeon).

Drawstring-type apparatus: This term is used herein to refer to astring, cord, or similar structure lining the perimeter of an openingand laced through eyelets for use in tightening, cinching, closing, orsealing off the opening.

Insufflate: This term is used herein to refer to pumping a fluid (e.g.,gas) into the interior of a reservoir or carrier in order to inflate thereservoir or carrier, thus providing a substantially open space forconducting the medical procedure at hand.

Laparoscopic port: This term is used herein to refer to an incision oraperture in the skin or body of a subject or patient that leads from anenvironment external to the body of the subject to an environmentinternal to the body of the subject. It is contemplated herein that alaparoscopic port can, for example, be an incision leading to theperitoneal cavity of the subject or even be a vagina of a femalesubject.

Laparoscopic tool: This term is used herein to refer to a surgicalinstrument that can be used during minimally invasive surgery, where thelaparoscopic tool can be inserted through a laparoscopic port.

Lining: This term is used herein to refer to a layer of material thatlines the interior or exterior of a bag, pouch, or carrier.

Means of tightening, cinching, closing, or sealing: This term is usedherein to refer to any suitable apparatus or methodology of enclosing atargeted specimen/tissue within a carrier, such that the interior of thecarrier is not in completely open communication with an environmentexternal to the carrier.

Operative internal cavity: This term is used herein to refer to spacewithin a subject or patient where a medical procedure is intended totake place. Examples of operative internal cavities include, but are notlimited to, peritoneal cavities, abdominal cavities, and pelviccavities.

Proximal: This term is used herein to refer to a position of a structurethat is closer to a user or operator (e.g., surgeon) than anotherstructure that is closer to the interior of a subject or patient.

Retaining carrier: This term is used herein to refer to a resilient bagor pouch that has an opening for receiving a specimen/tissue, where thebag or pouch can enclose the specimen/tissue and create an environmentfor performing a medical procedure on the specimen/tissue.

Suture tag: This term is used herein to refer to an apparatus connectedto a channel according to the current invention and use for the purposeof facilitating manipulation of the channel (e.g., withdrawing thechannel through the laparoscopic port).

Targeted specimen: This term is used herein to refer to tissue within asubject or patient intended to undergo a medical procedure, for examplemorcellation and removal from the subject or patient.

Withdraw: This term is used herein to refer to extracting an object orcomponent from the interior of a body of a subject or patient andpulling/bringing it to the exterior of the body of the subject orpatient (e.g., through a laparoscopic port). The object or component canbe withdrawn partially or fully. For example, a channel can be withdrawnsuch that a portion (typically a majority) of the channel is positionedoutside of the body and a portion of the channel is still positionedinside of the body. As another example, a morcellation system can bewithdrawn from the interior of the body by extracting the entireapparatus from the interior of the body, such that no remaining portionof the system remains inside the body.

The advantages set forth above, and those made apparent from theforegoing description, are efficiently attained. Since certain changesmay be made in the above construction without departing from the scopeof the invention, it is intended that all matters contained in theforegoing description or shown in the accompanying drawings shall beinterpreted as illustrative and not in a limiting sense.

It is also to be understood that the following claims are intended tocover all of the generic and specific features of the invention hereindescribed, and all statements of the scope of the invention that, as amatter of language, might be said to fall therebetween.

What is claimed is:
 1. A morcellation system, comprising: a pliableretaining carrier or pouch with a specimen-receiving opening that leadsfrom an exterior of said retaining carrier to a substantially hollowinterior of said retaining carrier, said retaining carrier insertableinto an operative internal cavity of a subject or patient, saidretaining carrier structured to receive a targeted, excised specimenwithin said substantially hollow interior; a means of tightening,cinching, closing, or sealing said specimen-receiving opening positionedon a perimeter of said specimen-receiving opening; and a plurality ofelongate, flexible laparoscopic tool- or trocar-receiving channelsextending externally from a lining of said retaining carrier at a spaceddistance away from said specimen-receiving opening and at a spaceddistance away from each other, said plurality of channels positioned onsaid lining of said retaining carrier such that said plurality ofchannel are configured to line up with laparoscopic ports on a body ofsaid subject, said plurality of channels structured to receive one ormore laparoscopic tools, said plurality of channels each having aproximal end and a distal end, said distal end of said each channelterminating at said lining of said retaining carrier within saidoperative internal cavity of said subject, said proximal end configuredto be withdraw external to said body of said subject when saidmorcellation system has been inserted into said patient or subject, saideach channel having a substantially hollow interior that is incommunication with said substantially hollow interior of said retainingcarrier, said retaining carrier having a first position and a secondposition, said first position being a desufflated position within saidoperative internal cavity of said subject with said specimen-receivingopening being open, said second position being an insufflated positionwithin said operative internal cavity of said subject with saidspecimen-receiving opening being close or cinched and said each channelis extended through a respective laparoscopic port on the body.
 2. Themorcellation system as in claim 1, further comprising: said operativeinternal cavity of said subject or patient being an abdominal or pelviccavity.
 3. The morcellation system as in claim 1, further comprising:said one or more laparoscopic tools selected from the group consistingof a trocar, a morcellator, a camera, a control instrument, and aninsufflation source.
 4. The morcellation system as in claim 1, furthercomprising: said means of tightening, cinching, closing, or sealing saidspecimen-receiving opening being a drawstring-type apparatus that ispulled relative to said specimen-receiving opening in order to reduce adiameter or length of said specimen-receiving opening.
 5. Themorcellation system as in claim 1, further comprising: said plurality ofchannels including a morcellator channel structured to receive amorcellator, a control instrument channel structured to receive acontrol instrument, and a camera channel structured to receive a camera,so that said morcellator can morcellate said targeted specimen withinsaid substantially hollow interior of said retaining carrier underdirect visualization of said camera while said control instrument holdssaid targeted specimen.
 6. The morcellation system as in claim 1,further comprising: an elongate suture tag attached to and positioned atsaid proximal end of said each channel to facilitate laparoscopicmanipulation of said each channel.
 7. The morcellation system as inclaim 1, further comprising: said second position of said retainingcarrier further including said closed or cinched specimen-receivingopening configured to pressed against an anterior abdominal wall withinsaid subject when said operative internal cavity is an abdominal orpelvic cavity of said subject.
 8. A method of performing minimallyinvasive laparoscopic surgery on a subject, comprising: providing aplurality of laparoscopic ports in a body of said subject; excising atargeted specimen within an operative internal cavity of said subject;inserting a morcellation system in a deflated position into saidoperative internal cavity of said subject, said morcellation systemincluding a pliable retaining carrier having a substantially hollowinterior and a closable or sealable specimen-receiving opening, saidspecimen-receiving opening providing for completely open communicationbetween said operative internal cavity of said subject and saidsubstantially hollow interior of said retaining carrier, saidmorcellation system further including a plurality of laparoscopic tool-or trocar-receiving channels extending from a lining of said retainingcarrier, said plurality of channels having an interior being in opencommunication with said substantially hollow interior of said retainingcarrier, said plurality of channels positioned at a spaced distance awayfrom said specimen-receiving opening and at a spaced distance away fromeach other, said plurality of channels being spatially aligned with saidplurality of laparoscopic ports, said each channel having a first endthat terminates at said lining of said retaining carrier within saidoperative internal cavity of said subject and a second end that isexternal to said body of said subject when said morcellation system hasbeen inserted into said patient or subject; withdrawing each of saidplurality of channels from said operative internal cavity through arespective spatially aligned laparoscopic port of said plurality oflaparoscopic ports; positioning said excised, targeted specimen withinsaid substantially hollow interior of said retaining carrier throughsaid specimen-receiving opening; tightening, cinching, closing, orsealing said specimen-receiving opening to enclose said excised,targeted specimen within said substantially hollow interior of saidretaining carrier, such that said substantially hollow interior of saidretaining carrier is not in completely open communication with saidoperative internal cavity of said subject; inserting one or morelaparoscopic tools into at least one of said plurality of channels,wherein said laparoscopic tool has a distal end disposed within saidsubstantially hollow interior of said retaining carrier and a proximalend disposed external to said body of said subject; insufflating saidretaining carrier to distend in order to form a protected environment;morcellating said excised, targeted specimen within said insufflatedretaining carrier in order to remove at least a majority of saidexcised, targeted specimen from said operative internal cavity of saidsubject; desufflating said retaining carrier; and withdrawing saidmorcellation system including said retaining carrier and said pluralityof channels from said operative internal cavity through a laparoscopicport of said plurality of laparoscopic ports, said retaining carrierenclosing any remnants of said excised, targeted specimen in saidsubstantially hollow interior.
 9. The method as in claim 8, furthercomprising: said operative internal cavity of said subject or patientbeing an abdominal or pelvic cavity.
 10. The method as in claim 8,further comprising: said one or more laparoscopic tools selected fromthe group consisting of a trocar, a morcellator, a camera, a controlinstrument, and an insufflation source.
 11. The method as in claim 8,further comprising: said step of tightening, cinching, closing, orsealing said specimen-receiving opening performed using adrawstring-type apparatus that is pulled relative to saidspecimen-receiving opening in order to reduce a diameter or length ofsaid specimen-receiving opening.
 12. The method as in claim 8, furthercomprising: said plurality of channels including a morcellator channelstructured to receive a morcellator, a control instrument channelstructured to receive a control instrument, and a camera channelstructured to receive a camera, so that said morcellator can morcellatesaid targeted specimen within said protected environment of saidmorcellation system.
 13. The method as in claim 8, further comprising:said each channel including an elongate suture tag attached to andpositioned at said second end of said each channel to facilitatelaparoscopic manipulation of said each channel.
 14. The method as inclaim 8, further comprising: said excised, targeted specimen being auterus in a female subject.
 15. The method as in claim 8, furthercomprising the step of: positioning said tightened, cinched, closed, orsealed specimen-receiving opening against an anterior abdominal orpelvic wall within said subject when said operative internal cavity isan abdominal or pelvic cavity of said subject.
 16. The method as inclaim 8, further comprising: said step of withdrawing said each channelfrom said operative internal cavity performed by: inserting a grasperinto a first laparoscopic port of said plurality of laparoscopic portsand withdrawing a first channel of said plurality of channels throughsaid first laparoscopic port, and inserting said grasper into a secondlaparoscopic port of said plurality of laparoscopic ports andwithdrawing a second channel of said plurality of channels through saidsecond laparoscopic port, wherein said step of tightening, cinching,closing, or sealing said specimen-receiving opening is performed afterwithdrawing said first channel but before withdrawing said secondchannel.
 17. The method as in claim 8, further comprising: said step ofwithdrawing said morcellation system from said operative internal cavityperformed by: inserting said each channel into said operative internalcavity except for one (1) of said plurality of channels, and applying aforce to said one channel in order to extract said retaining carrier andsaid each channel from said operative internal cavity.
 18. The method asin claim 8, further comprising: performing each of the steps of saidmethod of performing minimally invasive laparoscopic surgery on saidsubject under direct visualization of a camera.
 19. A method ofperforming a hysterectomy on a subject, comprising: providing aplurality of laparoscopic ports in a body of said subject; excising atargeted specimen within an operative internal cavity of said subject,said operative internal cavity of said subject or patient being anabdominal or pelvic cavity, said excised, targeted specimen being auterus in a female subject; inserting a morcellation system in adeflated position into said operative internal cavity of said subject,said morcellation system including a pliable retaining carrier having asubstantially hollow interior and a closable or sealablespecimen-receiving opening, said specimen-receiving opening providingfor completely open communication between said operative internal cavityof said subject and said substantially hollow interior of said retainingcarrier, said morcellation system further including a plurality oflaparoscopic tool- or trocar-receiving channels extending from a liningof said retaining carrier, said plurality of channels having an interiorbeing in open communication with said substantially hollow interior ofsaid retaining carrier, said plurality of channels positioned at aspaced distance away from said specimen-receiving opening and at aspaced distance away from each other, said plurality of channels beingspatially aligned with said plurality of laparoscopic ports, saidplurality of channels including a morcellator channel structured toreceive a morcellator, a control instrument channel structured toreceive a control instrument, an insufflation channel structured toreceive an insufflation source, and a camera channel structured toreceive a camera, so that said morcellator can morcellate said targetedspecimen within said protected environment of said morcellation system,wherein each of said plurality of channels includes an elongate suturetag attached to and positioned at said second end of said each channelto facilitate laparoscopic manipulation of said each channel, said eachchannel having a first end that terminates at said lining of saidretaining carrier within said operative internal cavity of said subjectand a second end that is external to said body of said subject,inserting a grasper into a first laparoscopic port of said plurality oflaparoscopic ports and withdrawing a first channel of said plurality ofchannels through said first laparoscopic port; positioning said excised,targeted specimen within said substantially hollow interior of saidretaining carrier through said specimen-receiving opening; tightening,cinching, closing, or sealing said specimen-receiving opening to enclosesaid excised, targeted specimen within said substantially hollowinterior of said retaining carrier, such that said substantially hollowinterior of said retaining carrier is not in completely opencommunication with said operative internal cavity of said subject,wherein said step of tightening, cinching, closing, or sealing saidspecimen-receiving opening is performed using a drawstring-typeapparatus that is pulled relative to said specimen-receiving opening inorder to reduce a diameter or length of said specimen-receiving opening;inserting said grasper into a second laparoscopic port of said pluralityof laparoscopic ports and withdrawing a second channel of said pluralityof channels through said second laparoscopic port, such that said eachchannel is withdrawn from said operative internal cavity through arespective spatially aligned laparoscopic port of said plurality oflaparoscopic ports; inserting one or more laparoscopic tools into atleast one of said plurality of channels, wherein each of said one ormore laparoscopic tools has a distal end disposed within saidsubstantially hollow interior of said retaining carrier and a proximalend disposed external to said body of said subject, said one or morelaparoscopic tools selected from the group consisting of a trocar, amorcellator, a camera, a control instrument, and an insufflation source;positioning said tightened, cinched, closed, or sealedspecimen-receiving opening against an anterior abdominal or pelvic wallwithin said subject; insufflating said retaining carrier to distend inorder to form a protected environment; morcellating said excised,targeted specimen within said insufflated retaining carrier in order toremove at least a majority of said excised, targeted specimen from saidoperative internal cavity of said subject; desufflating said retainingcarrier; withdrawing said morcellation system including said retainingcarrier and said plurality of channels from said operative internalcavity through a laparoscopic port of said plurality of laparoscopicports, said retaining carrier enclosing any remnants of said excised,targeted specimen in said substantially hollow interior, said step ofwithdrawing said morcellation system from said operative internal cavityperformed by: inserting said each channel into said operative internalcavity except for one (1) of said plurality of channels, and applying aforce to said one channel in order to extract said retaining carrier andsaid each channel from said operative internal cavity; and performingeach of the foregoing steps of said method of performing minimallyinvasive laparoscopic surgery on said subject under direct visualizationof a camera.